Monday, August 21, 2000
The University Daily Kansan
Section C·Page 17
Uninsured students struggle in medical limbo
By Katie Hollar
Kansan staff writer
Angela Olliver hurts. The pain shoots out from her lower abdomen — and her pocketbook.
Her body has hurt for several months now; she doesn't know why and neither do her doctors.
At first, doctors thought the a 26-year-old Roeland Park senior had ovarian cysts. They scheduled surgery to remove them. Doctors opened her up and realized that wasn't the problem.
As her pain continues, the bills add up. Surgery. Blood work. X-rays. Emergency room visits. Exams. Painkillers.
"I wouldn't be here if it wasn't for Demerol," she said.
But there's a pain Demerol can't help.
Oliver doesn't have insurance.
She estimates that so far, she owes $6,000 to Lawrence Memorial Hospital.
While the severity of her illness may be unusual, the insurance predicament isn't. The American College Health Association estimates that 11 percent of undergraduate college students have no health insurance, and the remaining 89 percent may have less coverage or more restricted coverage than they realize.
In addition, 36 percent of college students are covered under their parents' policies, the Association reports. Most of that coverage will end when the student reaches a certain age, usually 24.
In Oliver's case, she worked full-time last year and had benefits. When she came back to school to get a second degree, she gave them up.
Now she can't afford to buy insurance herself.
"And with what's going on now," she said, "premiums would be a nightmare."
So she'll just have to pay her bills herself.
Specific insurance statistics are not documented for University of Kansas students. But 1,346 undergraduate students are older than 25. Add graduate and law students and that number exceeds 5,000. Not every one of them is uninsured,
but the number could approach 1,000 uninsured students.
Students such as Oliver are in the dangerous limbo between their 24th birthday and full-time employment. If they get sick, there are only two choices: pay out of pocket or go it alone.
It's a lose-lose situation.
Some students decide to neglect emergency treatment.
Kris Graves, Lawrence graduate student, got food poisoning last month. He refused to go to the emergency room. He couldn't afford it.
"I was sick for four days," he said. "It was horrible. I was throwing up every four hours. My girlfriend called Poison Control and helped me out, but I'm sure the ER would have been better."
Graves, who was dropped from his parents' insurance on his 24th birthday, thought the emergency room visit would have cost $400 — which is $400 the part-time hotel bellman didn't have.
In fact, an average emergency room bill from Lawrence Memorial exceeds Grave's prediction. About $300 is charged for the doctor alone, $100 for the facility and maybe $75 for medicine.
A representative in the hospital accounting office said payment plans could be arranged. Patients can divide their total bills into six monthly payments, she said. For the bill above, that would be almost $80 each month.
Graham Bailey, public relations director for Blue Cross-Blue Shield in Topeka, said his company usually dropped coverage when students turned 24 or got married.
"The idea is that, when you become an adult, you get dropped off your dad's car insurance, your parents' health insurance," he said. "It is a practice that goes on in the industry, but I can see how it could cause some problems."
Most colleges offer some inexpensive health insurance plan, and premiums are lower for healthy young adults, Bailey said.
Bailey said he understood the dilemma but saw other problems for 20-somethings.
insurance." he said.
"It's probably no more problematic than someone who gets out and makes $22,000 and their employer doesn't offer health
The University of Kansas offers its own plan. For students younger than 25, the yearly rate is $480, which averages out to $40 each month. Students age 25 and older pay $856, or $72 each month. The plan is available through G-M Underwriters.
Pre-existing conditions, like Oliver's, require a 12-month waiting period before insurance will pay for any treatment.
"The plan wouldn't do me any good at all," she said. "That's 50 bucks a month I just don't have. Especially if it's not helping me."
After some significant lobby efforts, the Graduate Teaching Assistant Coalition secured a health plan for University teaching assistants for the 1999-2000 academic year. The policy is underwritten by Gerber Life Insurance Policy. To be eligible, students must be in a half-time graduate teaching or graduate research position.
Because teaching assistants are employees, the University pays part of the monthly insurance fee. A teaching assistant 25 or younger will pay $19.40 each month for the comprehensive plan and $7.25 each month for the basic plan. The plan would cost a GTA between 26 and 30 years old $27.30 for the comprehensive plan and $10.17 each month for the basic.
Both plans waive deductible fees if the student is treated at Watkins Memorial Health Center.
But Bailey acknowledged that with student loans and low income, even plans like the University's can be too pricey.
Oliver isn't a graduate student, and Graves doesn't work as a teaching or research assistant, so neither qualifies for the lower rates.
meet those responsibilities."
"There's a window in your 20s,
I remember being there, where you're losing your youth."
Bailey said. "With that comes a whole new world and some whole new responsibilities.
Sometimes you're not ready to
univer's not. Her livelihood comes from wages earned at a part-time job at the School of Social Welfare and one night each week at The Jazzhaus, 926-1/2 Massachusetts St.
This semester, the illness and the stress it brings with it also has cost her a 4.0 grade-point average. She's looking at getting the first two B's of her college career.
She says the pain, a dull pain radiating from her lower abdomen, goes on all the time. On a scale of one to 10, with one being a papercut and 10 being sawed in half, she said it averaged a seven.
She's trying hard now to wean herself off medication.
"No one can know what it's like to live with chronic pain until they do it," she said. "It affects your entire being. You don't like to do any thing. Your relationships suffer. It just takes over your life."
They haven't confirmed it yet, but doctors think Oliver has endometriosis, a disease occurring where the uterus lining grows outside the uterus. The growth can suffocate the organs around the uterus, like the varies or fallopian tubes.
She might not be able to have children.
The usual treatment for endometriosis is a combination of medication and surgery. In severe cases, doctors may perform a "radical" surgery — removal of the uterus and both ovaries.
Oliver tries not to think about the worst-case scenarios. She has bills to pay — about $8,000 of them, and most are due on July 1
Oliver said her doctor's office has threatened to turn her into a collection agency if she doesn't make that deadline.
thought if you made a conscientious effort to pay and showed them what you made, they wouldn't turn you in. But they will." she said.
She tried to get help through Social Rehabilitation Services. SRS could have helped her if she was poor or pregnant, she said, but for a middle-class college student, there is no help.
"There should be help out there for people who are trying
to better themselves, trying to do something with their lives." she said. "I'm being punished for not being pregnant."
The best solution, she said,
would be for insurance companies to extend coverage for students until they graduate.
Bailey doesn't think that will happen, though.
"The cutoff used to be younger than 24," he said. "There's just a threshold age. There always has been. There probably always will be."
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